What You Need To Know About Medicare Part A Coverage

What You Need To Know About Medicare Part A Coverage

Medicare is a government service that helps millions of aging people access the healthcare coverage they need at a low cost. There are two types of Medicare: Part A and Part B. Understanding Medicare regulations are complex, but it is most important to know what health services are covered. Medicare A pays for inpatient hospital care, while Medicare Part B pays for doctors’ visits, lab tests, and preventative services and supplies. Here is everything you need to know about Medicare Part A, including covered services and costs. 

What Is Medicare Part A? 

Medicare Part A is considered hospital insurance. Most people have Part A and Part B coverage to pay for different medical expenses. Members typically pay a deductible or copayments for medical care, but usually at reduced rates. Part A is necessary for many aging adults, especially those that require inpatient hospitalization services. 

What Does Medicare Part A Cover?

Part A typically pays for hospital stays, hospice care, and skilled nursing help, depending on your location. Medicare Part A typically pays for services received through the following providers:

• Critical care hospitals
• Acute care hospitals
• Rehabilitation services
• Inpatient mental health service
• Long-term care hospitals 
• Inpatient research hospitals 

Medicare Part A is used explicitly for inpatient medical services while Part B pays for outpatient health services. This type of coverage is also used to pay for home health services. Part A typically pays for 100% of the cost of home health care services, including skilled nursing, hospice, and in-home physical therapy. However, remember that Part A does not cover in-home personal care services if they are unrelated to your condition. Also, it does not cover 24-hour home health care if it is not necessary for your treatment. 

If you need medical equipment as part of your treatment, it is typically covered under Medicare Part B. For instance, if your doctor recommends a walker, oxygen tank, or wheelchair as part of your care, it is covered under Part B. Policyholders are typically responsible for paying 20% of approved medical equipment. 

Does Medicare Part A Cover Skilled Nursing Services?

Medicare Part A covers the cost of staying in skilled nursing facilities related to a covered illness or injury. However, specific exclusions apply. You must remain in the facility for at least three days, starting on the day you are admitted to the facility. The day you leave the facility does not count toward the minimum stay requirement. Only inpatient skilled nursing services are covered under Part A. 

A facility must be certified by Medicare to qualify. The following services are covered at approved facilities: 

• Meals
• Skilled nursing care
• Private or semi-private room
• Rehabilitation services
• Dietary and nutrition services
• Health supplies used in the facility
• Medication used in the facility
• Transportation to and from the care center

The rules for covered services vary slightly if the patient is also receiving hospice care. Part A may also pay for additional services such as counseling or grief therapy in these cases. However, Medical Part A only covers meals and room expenses if the medical staff requests temporary inpatient stays for symptoms alleviation. 

What Are the Costs Associated with Medicare Part A? 

The costs associated with services rendered under Medicare Part A vary depending on the patient. Most people do not pay a monthly premium for coverage under Medicare. The expenses you pay correlate with how long you worked before retirement. Those who worked for at least ten years do not pay a monthly premium. If you have worked for less than ten years, you must pay a monthly premium. Depending on other factors, you will pay between $259 and $471 a month. 

Is Medicare Part A Free For People Over Age 65?

Medicare Part A is free for those who worked a certain number of years before retirement. You are eligible for a premium-free Part A policy if you are 65 or older and you meet the following requirements:

• You currently receive Social Security benefits
• You are eligible for Social Security benefits, but you do not yet receive them
• You or your spouse is a retired government employee 

There are certain circumstances when those under age 65 can receive Medicare Part A for no monthly cost. You may also qualify if you have a covered medical condition such as end-stage renal disease. You do not have to pay a premium if you have received Social Security benefits for at least two years. Make sure and contact a Medicare healrht insurance broker if you want to know more about your eligibility. 

Contact Sackett & Associates Insurance Services

Are you looking for a Medicare health plan? Sackett & Associates Insurance Services is an independent insurance provider specializing in matching customers with the best health coverage. We have been helping families, individuals, and groups find the best insurance for over 40 years. Contact us today to speak with one of our licensed insurance brokers.